Book reviews

The title of John Williams's book signifies that sparks of Emersonian thought ignited the tinder of Melville's art. With no record of any Emerson-Melville acquaintanceship or exchange—as existed between Hawthorne and Melville or Emerson and Whitman—Williams's task is more difficult than most studies of literary influence or reaction. "White fire" also implies a degree of incendiary incandescence against which Whitman's "I was simmering, simmering, simmering; Emerson brought me to a boil" seems rather tepid. Because this book promises so much, interested readers will be disappointed by what it delivers.

A Physiological System of Nosology with a corrected and simplified Nomenclature. By John Mason Good, F.R.S. &c. &c. Dedicated (by permission) to the Royal College of Physicians. 8vo. pp. o(i6. Cox and Co. 1817. N a preliminary dissertation, we are informed that the plan of the work was laid down as early as the year IS08>* thus exactly according with the precept of Horace? Nonum prematur in annum; and, indeed, when we consider the length and labour of the work, we are almost inclined to wonder how a practitioner, engaged in professional duties, and other literary pursuits, could accomplish it so soon.
Having so often expressed our dissatisfaction at all the nosological attempts hitherto made, we had determined to impose a peculiar restraint on ourselves in the present instance, lest we should be warped either by prejudice or petulance. With this view we have paid the closest attention to the work; and shall, as often as possible, leave the author to speak for himself, and the reader to draw his own inferences.
"The main object (says Mr. Good in his preliminary Dissertation) of the present attempt is not so much to interfere with any existing system of nosology as to fill up a niche that still seems unoccupied in the great gallery of physiological study. It is that, if it could be accomplished, of connecting the science of diseases more closely with the sister branches of natural knowledge; of giving it a more assimilated and family character; a more obvious and intelligible classification; an arrangement more simple in its principle, but more comprehensive in its compass; of correcting its nomenclature, where correction is railed for, and can be accomplished without coercion; of following its distinctive terms as well upwards to their original sources, as downwards to their synonyms in the chief languages of the present day; and thus, not merely of producing a manual for the student, or a text-book for the lecturer, but a book that may stand on the same shelf with, and form a sort of appendix Several pages follow remarking the advantages and disadvantages of the Cullenian nosology, in which we could gladty have spared the allusions to the boundaries attempted by the late ruler of Trance, as well as a comparison of Cullen's locales to the cryptogamia of botanists; and still niore his quotation from the Inferno of Dante, in illustration of diseases for which Cullen could find no place in either of his divisions. That we may not, however, do injustice to ?ur author, wre shall give the following specimen of his mode of enlivening a dull subject by an occasional sally of humour. " Dr. Cullen, however, it must be admitted, has been as ingenious as he conld; and contrived the means of giving, throughout all his classes, an entrance to diseases that have very little claim to admission. But the consequence is, that they make a sad medley, and, in many cases, have not the slightest affinity or family resemblance; of which we have a striking example in psora and fractura, which follow in immediate succession in the class of local disorders. Psora (itch J can scarcely be callcu a local affection, unless the term be appropriated Sf'4f Critical Analysis^ appropriated to the skin generally, as distinguished from all the other parts of the frame; but, in this case, trichosis and lepra should have been placed in the same class, instead of in that of cachexies; while fractura could have no pretensions to such a class unless when compound. But it must certainly puzzle the best medical scholar in Europe, who is not acquainted with Dr. Cullen's arrangement, to discover the least, connexion between itch and broken bones, and especially such a connexion as not only to draw them into the same class, but to make them immediate neighbours in the same order. Dr. Cullen, however, has ascertained that they are both local disorders, which entitles them to a common class, and both dialytic disorders, or produced by a division of continuity, which entitles them to a common order: and hence to the question, * why is the itch like a broken bone]'?the student's answer is, * because it is a dialysis:' an answer somewhat wanting, perhaps, in professional gravity, but the only one that can be given. And here it is probable we must stop; for there seems no possibility of advancing farther, and assigning any reason for the very close intimacy allotted to psora and fractura by fixing them in immediate succession., Yet there is, perhaps, quite as much difficulty in determining what could be the author's motive for placing nostalgia in any part of the same class.
" 2. It is impossible to take a survey, however brief, of Dr. Cullen's system, and not to notice his very extraordinary confusion of genera and species. And the author is the more induced to advert to it, because, extraordinary as such a confusion must appear to all who are acquainted with the difference, Dr. Cullen is by no means the only nosologist of our own day who has run into the same mistake, as will easily be perceived before the close of this dissertation." Some very fair remarks follow on the impropriety of making single diseases so many genera. " A genus," says 3Vlr. G. " is a mere abstract term, a nonentity in nature, but highly useful,"?meaning, we presume, for artificial arrangement.
Many other errors and inconsistencies are pointed out; and, even in the very best part of the Cullcnian system, many inaccuracies are detected.
The writers on general or universal nosology being thus dismissed, a few remarks suffice for those who have made the attempt on a more confined scale. Selle's Methodical Pyretology is shewn to be very imperfect. Ploucquet's System, we are told, "is by far too complicated, and certainly not without its nebulosity?singularly distinguished by the author's fondness for long crabbed words. Pinel's Philosophical Nosology is " too refined fo? popular use, and too indistinct for practical benefit;" but his " arrangements of mental alienation" have been found very useful. To the other parts of his .work many objections are added, which we conceive it unnecessary to notice.

Next
Mr. Good's Physiological System of Nosology. gi5 Next follows a view of the authors who have attempted to improve on the Cullenian system. Macbride has great credit " for a nice skill in the arrangement of his genera and species, in which there is a neatness and simplicity of which the author has endeavoured to avail himself, wherever the structure of his own system would allow, and which he has often left with regret when it would not." Dr. Chrichton is next produced, and Mr. G.'s objections stated, excepting to the part which relates to mental derangement, and even that is not without its faults.
Dr. Darwin's system is commented on with much pleasantry ; and, as we shall have occasion to mention it again, we are glad of an apology for making a further transcript. " But (says Mr. Good) the direct death-warrant of the system consists in his making every single proximate effect (in common language, proximate cause or symptom) a distinct disease; for, as the same proximate effect or symptom may be produced by several, or by each of what Darwin calls proximate causes, and which constitute his classes, it follows that the very same species or specific disease must, in such cases, belong equally to some order or other of several, or of all the classes of his system. And such, to the student's embarrassment and surprise, lie will find, upon examination, to be the real fact. Thus, while variola (small-pox) is arranged under cl. 11. ord. i. gen. hi., cmptio variolte (small-pox eruption) occurs under cl. iv. ord. I. gen. ii. So hydrophobia appears first in I. in. i. and afterwards in in. i. i.; diabetes in I. hi. ii. and again in iv.HI. i.; palpitation of the heart in i. n. i. and again in I. III. iii. being twice in the same class: and of so many others." The author next noticed is Dr. Parr, of whose Dictionary we should say, Mr. Good speaks in terms of exaggerated praise, were it not for a sentence so just as at once to convince us what we are to expect from such a medical writer. " He [Dr. Parr] was his [Mr. Good's] colleague in conducting, for come years, two of the most extensive literary works of the present day, though not the Dictionary in question; and lie can affirm, from a full knowledge of his talents, that he was a man of deep study, comprehensive capacity, and extensive learning. His mind, indeed, was so widely fraught with miscellaneous information, that few subjects could come amiss to him. His Dictionary gives evident proof ?f his having been alive to every novelty in his own profession, and ?f his readiness to allow its merits. He was far more disposed, indeed, to be satisfied with the opinions of others than with those of himself; and chiefly failed in a want of deference to his own judgment.
In laying down the outline of his system of diseases, which he only attempted upon a full conviction that a work of this kind was extremely wanted in the medical republic, he had his eye chiefly directed to the nosological method of Selle, and the botanical method of Jussieu. It follows, therefore, that.his primary division would 216 Critical Analysis. would consist not of classes, but of what he intended to be natural orders or families. These orders are twelve, whose names are taken from the classes or orders of Sauvages or Cullen, with the exception of one, suppressorii, which is borrowed from Linneus. " Here again, therefore, we have a great and noble aim, whatever be the success of its accomplishment. But, as a natural system, even in botany, is to the present hour, and perhaps always will be, a theoretical rather than a practical idea, there seems very little expectation that it can ever be realised in mcdicine." At present we shall only remark, that we do not consider "a mind widely fraught with miscellaneous information," or " the conductor of two of the most extensive literary works," as expressions complimentary to a physician or a medical ?writer.
Lastly, Dr. Young's C? Introduction to Medical Literature,, including a System of Practical Nosology," is, in our opinion, very fairly estimated. <c Though limited to a single 8vo. it comprehends a complete course of medicine, and directs the student to the best authorities and sources of information ; in this respect answering the purpose of PJouquet's seven 4to. vols, with a great saving of expense, a prodigious saving of time, and by a far nearer and pleasanter pathway."* It is not to be wondered if even Dr. Young failed, like his predecessors, in his attempts at nosology. His plan, however, comes the nearest to Mr. Good's, though essentially distinct. We ought to add that Dr. Young published in "1813; and it has already been remarked that Mr. Good's work has been nine years on his table. Whatever similarity, therefore, may be detected, must arise from a coincidence of opinion, and not from plagiarism. This general review concludes with a slight notice of those nosologists who have confined their labours to <{ a single family or group of diseases." To the name of Selle, Pinel, and Crichton, are now added Plench, Willan, Abernethy, and Bateman. After a few remarks on the merits of each, the author commences his own plan by some observations on medical nomenclature: A considerable portion of this, he observes in a note, was published in the Memoirs of the Medical Society of London, and for which the author received the Fothergillian medal. There can be no difficulty in showing the absurdity of many of our terms, the erroneous *' We are glad of this opportunity of doing justice to Dr. Young's book. Our remarks on it at the time were confined to a certain passage, which, from the nature of the performance, seemed the most candid method of pointing out what the reader might expect from the whole, . ..

opinions
Mr. Good's Physiological System of Nosology. <217 opinions on which they were originally formed, nor the propriety of changing them. But, in the latter, the difficulty is great. As we remarked before,* to alter the terms adopted fry authors universally respected, and in well received works, ;.s a violence that few will submit to. This difficult}'' may, however, be confined to the present generation, and be greatest in us who are arrived at an age when we are apt to become laudatores temporis acti. Besides this, we are forced acknowledge, that, having found the study of medicine quite sufficiently laborious, and longer than we can expect ?ur usefulness in life to continue, we have been always shy 9f encumbering ourselves with any addition to our troubles.
"W hat we have just said, will be considered as a further acknowledgment of the danger we feel lest prejudice should direct any of our remarks; and we again repeat the wish, that the reader, whilst he peruses us, would keep that danger in view. After this confession, we enter on the " Scope of the present Design. " I. It is obvious then (says Mr. G.) that the healing art stands in considerable need of improvement in its two important branches of NOSOLOGICAL ARRANGEMENT and NOMENCLATURE : and it is, among other points, to an improvement in these two branches that the ensuing pages are especially directed. " In giving an outline of what the author proposes in order to accomplish this purpose, it is of little consequence which of these two divisions shall first pass in review before us: let us then begin with ^hat of language or nomenclature, as being, perhaps, freshest in the memory.
. " In the hope of giving some degree of improvement to the medical vocabulary, as far as he may have occasion to employ it, the author has endeavoured to guide himself by the following general .rules. Firstly, a strict adherence to Greek and Latin terms alone.
Secondly, a use of as few technical terms as possible, and consequently a forbearance from ull synonyms. Thirdly, a simplification of terms, as far as it can be done without violence or affectation, both in their radical structure and composition. Fourthly, an individuality and precision of sense in their respective use." In taking a view of the languages best suited for nomenclature, no scholar can fail to prefer the Greek, which by * See London Med. and Phys. Journ. vol. xxv. p. 56. It may be fight to remark, that the nomenclature is much improved since its former publication; and, iu one instance, the author has attended to our hint, or, which is more probable, improved his terms by subse. Critical Analysis common consent has found its way into every branch of philosophy, in proportion as each has been better cultivated, and hence become more precise in its terms. Whenever it is found necessary to make compound terms, the Greek has so many advantages, that even the Germans, with a language scarcely less flexible, have not scrupled to submit to the general choice of all Europe. Mr. Good has also the advantage of early authorities, from the best writers, for most, if not all, his generic terms. In his specific terms, he is less scrupulous; but, even here, he rarely wanders beyond the Greek and Latin. The next object in philosophical language is simplicity. We shall copy the following paragra ph as a specimen ; it may come before us again, when considering the execution of the work, for, at present, the reader will recollect we are only engaged on the preliminary dissertation. " 2. The machinery of every art and science (says Mr. G.) becomes simpler, and its auxiliary powers fewer and less needed, as it advances towards perfection. It is the same with their technology. While we are but loosely acquainted with the principles of an art we speak of them with circumlocution, and employ more words than are neccssary, because we have none that will come immediately to the point. As we grow more expert we learu to make a selection; we give to many of them a greater degree of force and precision; and separate those that are thus rendered of real value from the " leather and primello," the heavy outside show of useless and unmeaning terms with which they are associated; and thus gain in time as well as in power. In unison with these ideas, the author, as soon as he has pitched upon a word that will best answer his purpose, will he found, as he hopes, to adhere to it wherever he has had occasion to advert to the same idea, without indulging in any play of synonyms, or difFerent terms possessing the same or nearly the same meaning. Marisca and haemorrhois have been equally employed by medical writers to distinguish the disease which we call vernacularly piles.
The first is a Latiu term, and refers to the tubercles of the disease, and the secoud a Greek, and refers to a discharge of blood which occasionally issues from them. As commonly used they are direct synonyms, notwithstanding this difference of radical meaning, and either might answer the purpose; the diversity of the disease being pointed out by distinctive adjuncts, as caeca, mucosa, or cruenta. Sauvages and Sagar, however, have employed both; but have laboured to establish a difference, without having succeeded even in their own judgment. So that, in these writers, we have one and the same disease described under two distinct genera in distinct classes;' the first occurring in Sauvages under class I. ord. v. entitled, vitia, CYstides: the other under class iv. ord. ii. entitled, fluxus, Alvi flux us, and introduced with this remark, "HiEMORRHOi oes vero nihil aliud sunt quarn maiiiscje, gazae apud Aristotelem." Id Mr. Good's Physiological System of Nosology. 219 In the present system, marisca* is alone retained; and the author lias preferred it to haemorrhois, first, because haemorrhage is only a symptom that characterises a peculiar species, or rather, perhaps, a variety of the disease ; and next, because hasroorrhois, or rather haemorrhoids, (cilpoppofttti) was employed among the Greeks, as well vulgarly as professionally, in a much wider sense than that of modern times, and imported flux of blood from the vagina, as well as from the anus; and, in fact, from any part of the body, when produced by congestion and consequent dilatation of the mouths of the bleeding vessels, which were supposed in every instance to be veins. So Celsus, " Tertium vitium est, ora venarum tanquam capitulis quibusdum surgentia quae saepe sanguinem fundunt: al^o'ppoi^, Graeci vocant. Idque etiam in ore vulvee faeminarum incidere consuevit." To the same effect Hippocrates, Lib. de Morb. Mulier. Galen uses it in a still wider extent, De Morbus Vulgaribus'A and hence the woman with an issue of blood in St. Matthew, cli. ix. 20, is termed in the Greek text yvvri a.ipopo3o-a..% Gaza (y??a)> the term used by Aristotle, wouid have answered as well as marisca, but that it is less common in the present day, and an exotic term even in the Greek. Hesycliius calb it a Persian word, and Scaliger coincides with him; translating it, "thesaurus, reditus, tributus," "a treasury," or place of deposit or accumulation, chiefly of tribute or taxes. It is rather an Arabic than a Persian terra, though both countries use it under different inflexions. The Arabic root is ? (khazi) 1 a blush or ruddy flush,' whether from fulness, shame, or modesty; whence the verb (khaza)' to produce blushes, erubescence, or suffusion;' and hence (khazan) in Persian, signifies' autumn, or the season of fulness and erubescencewhile (kha-" * The term occurs in Juvenal, in its medical import, ii. 12. podice levi Caeduntur tumidae, medico ridente, marisc^e. " In Martial it occurs frequently in the literal sense of fici, * fleshy or succulent figs or raisins.' The spongy and succulent bulrush of the marshes, or grounds overflowed by the sea, was called nuaiscus, from its habitation d mari: and hence, probably, the name of the spongy and succulent tubercles which constitute the piles. Our English marsh has the same origin as mariscus." " f Comm. vi. cap. xxv." " t Sauvages, not sufficiently attending to this extensive sense of th,fe term among the Greek writers, represents this disease in St. Matthew as a marisca cruenta, or case of bleeding piles, instead of a catamenial haemorrhage. ' Hajmorrhois, h Grasce aima et rheo est fluxus sanguinis ex mariscis ; unde mulier in Evangelio luemorrhoissa dicta fuit.' Vol. i. p. 164. Jpud Mariscum." [? The Arabic characters are in every place given by Mr. Good, but omitted in our review, as unnecessary for the oriental readers, and useless to others. Every one also knows the difficulty of procuring a correct copy of them.?Edit.] Ff 2 zain) qqo ? Critical Analysis. zain) in Arabic, is 'a garner, treasury, or repository for the fulness of the autumnal months;' literally cella, cellula, gaza, or gazojthylacia, as explained by Hesychius." The above passage may seem to contain more learning than is necessary ; were this the only objection, Ave should readily excuse it, especially as it introduces us to a most important part of all science, and much less attended to in medicine than in any other. We mean those ezex nlspoevlac, the prefixes and affixes of the Greek language. If Mr. Good had done nothing more than call the attention of medical writers to precision in this single instance, Ave should admit the great, services he had rendered us. The subject, and a few others to the same purpose, occupies more than twenty pages of close printing, which, though not at all too much, is more than we can, injustice to the author, transcribe or epitomize. It may, however, afford some gratification, when we assure him, that, after perusing it three times with increased attention, we have found every time fewer objections to make.
This division of the work concludes with an inquiry into the various senses in which authors have used several terms of frequent occurrence. Among these, we meet with asphyxia, hemerolopia, nuctolopia, asthesia, exanthema, pyrexia, accessio, insultus.?We wish the author had extended the number, and made his remarks still longer. Having completed his observations on language, Mr. G. proceeds?
" A knowledge of the animal frame involves a deep and comprehensive acquaintance with three distinct branches of natural science; anatomy, by which we become acquainted with the structure' of this frame; physiology, which teaches us its various functions; and nosology or pathology, which unfolds to us the diseases to which it is subject. Unfortunately each of these branches has hitherto been taught by a different, instead of by a common, method; and hence the student, instead of proceeding with each at one and the same time, and with a single expenditure of labour, is compelled to apply himself to every one separately, and by a kind of new and unconnected grammar." " Having conceived the possibility of a nosological system, whose primary divisions should take a physiological range, and follow up the diseases of the animal fabric in the order in which the physiologist usually develops its organization and its functions, the author had next to determine at which end of the series he should begin; Whether with Ilaller, at the first and simplest vestige of the living fibre, and pursue the growing ens through all its rising stages of evolution and elaboration to its maturity of figure and sensation; or, with the physiologists of later times, to take at once the animal frame in its mature and perfect state, and trace it, from some well-defined and prominent function, through all the rest; which, like links in a C ? 1 --circular Mr. Good's Physiological System of Nosology. ?21 circular chain, may be said to issue from it, and to be dependent on its existence and properties. " The author was soon led to a preference of the second scheme.
It is by far the simpler of the two, and directly harmonizes with the fundamental principle, which runs through all the systems ol zoology, botany, and mineralogy, of forming the arrangement and selecting the characters from the most perfect individuals as specimens. He decided, therefore, upon taking the more prominent functions of the human frame for his primary or classific division, and tlie more important of their respective organs for his secondary or ordinal; and without tying himself to a particular distribution of the former in any authorized or popular use at the present moment, to follow what appears to he the order of nature in her simplest and most intelligible march. " To repair the exhaustion which is constantly taking place in every part of the body from the common wear and tear of life, it is necessary that the alimentary canal should be supplied with a due proportion of food, the procuration of which, therefore, constitutes, in savage as well as in civil society, the first concern of mankind. The food thus procured is introduced into a set of organs admirably devised for its reception; and its elaboration into a nutritive form constitutes what physiologists have denominated the digestive function.
The diseases then to which this function is subject will be found to create the first class of the ensuing system." The function of respiration follows; sanguification next.
Then the brain and nervous system ; "the sexual function;'* 222 Critical Analysis. ought rather be among the exanthems. That Dr. Parr, of whose dictionary he speaks so highly, places pes I is in the order of exanthemata, Cullen expresses his doubt; but Parr, in a subsequent part of his dictionary, declares, that bis own arrangement is improper; that pestis ought to be reduced to a variety under the " asthenic remittents." Similar difficulties occur in chlorosis, but Mr. G. very justly observes, that the same difficulties occur in all the attempts at arranging the other productions of nature into any artificial classes.
In all such cases, we are advised to wait for additional information, and the author conceives, " It is not improbable that some future nosologist (should the present work have any pretensions to futurity) may be able to assign more correct places to several of the geuera or species of,the ensuing arrangement than those they now occupy. It should be well remembered, however, that the principle of this arrangement consists in determining the proper class of a disease from the generalfunction that is injured, and not from any particular organ, which only regulates the subordinate divisions: and that, where two general functions are injured at the same time, that constitutes the class which appears to be most prominently affected. Thus scrofula and scabies, which seldom extend deeper than the secretory vessels of the skin, belong necessarily to the class ECCRITICA, or that comprising diseases of the exceknent function; while variola and rubeola, though equally occupying the surface, belong to the class hjematica, or the diseases of the sanguineous function; which, in both these cases, is primarily and chiefly affected, as is obvious from the pyrectic action of the heart and arteries. So, while gastritis and enteritis belong also, as inflammatory affections, to the Hhematic class, dvspepsy and cholera, though disorders of the same organs, must necessarily be referred to the class CCELIACA, or that comprising the diseases of the digestive function, this being the part of the animal economy which is hereby chiefly or wholly disordered.
"It may, perhaps, be objected that this is to travel over the same region a second or even a third time. It is, however, always in pursuit of a different object. It is to follow up the family of diseases that appertain to a particular function; while, to avoid having our attention distracted, we leave every other function and the diseases belonging to it, untouched. We pursue the same plan in zoology, in botany, in mineralogy. In a common region we discover discrepant specimens and bring them home at different times; 'exploring it on one occasion for one purpose, and on other occasions for others: and we then separate and arrange the productions into different classes and orders for scientific study, notwithstanding that nature has produced them in a common quarter." Mr. Good gives several cogent reasons for excluding dolores as a genus, or species, and for arranging them among the symptoms of those affections in which they usually occur.
Lastly, Mr. Good's Physiological System of Nosology. 223 Lastly, we are informed, that the vernacular synonymes are added in the three modern languages, English, German, and French. This the author calls a new attempt. In England, we believe it is so, in works strictly nosological.
His technical synonyms are likewise derived from the three most extensive languages ot antiquity?Greek, Latin, and Arabic. Occasionally, where the Arabic names are Persian, he has added the initials, or other marks, of these cognate tongues; and, in a few instances in which they are peculiarly expressive, he has also superadded Persian or Turkish names, even though different from the Arabic. At times, indeed, the Arabic writers themselves employ a Persian or a Syriac term, for many of them were Persians or Syrians by birth, &c. This leads the author to a consideration of oriental literature, the cultivation of which, he inforces with much eagerness, concluding, at last, with a recommendation of Galen and Celsus among the ancients for all that is contained in the writers antecedent to the Arabian Caliphats.
We have thus completed our abstract of the preliminary dissertation with as little interruption as possible, that we might not be suspected of lessening the interest the reader should feel, or of inducing him to form a premature judgment.
We shall now proceed to offer our remarks on the passages as they have occurred.
Had Celsus, Aretanis, Boerhaave, Mead, or Sydenham, attempted unsuccessfully any thing like a nosological table, we might have admired the boldness of each of their successors in so arduous a task : Quern si non tenuit magtiis tamen cxcidit ausis. But, what resemblance is there between the arrangement of some of these illustrious writers, and those systems of nosology which have sprung up since ? Sydenham, it is true, expressed a forlorn wish, but he lived to witness the dreadful effects of such an attempt for that class of diseases, in the history and treatment of which he has left scarcely any thing unfinished * We perfectly agree with Mr. Good, that an alphabetical arrangement is not to be considered an attempt at a system of nosology. On the contrary, is it not a tacit acknowledgment in the author, that, for want of a better method, he has recourse to one which breaks every catenation H)f the various parts, and makes each article a distinct series of observations and instructions? What Mr. Good calls the duration of diseases, is, indeed, a most important distinction, when explained by the terms * Compare his preface with his remark afterwards, that the malignant fever lias destroyed more than the sword.?Was this a prophecy or the influence of the word Typhus in our own days? i acuta Si2i> Critical Analysis. acute and chronic. This is the true natural division, and means no more than to distinguish between those diseases, which require the immediate interference of the physician, and those which admit of deliberation. Happy were it for mankind, had that distinction been as constantly kept in view as it has been invariably enforced by the ablest writers. We are at a loss to conceive, what can be meant by taking "anatomy for the modification of nosology." None of the writers instanced attempted any thing like nosological systems, and Dr. Mead, who is described as bringing up the rear, expressly tells us, in the passage to which Mr Good refers, that the animal machine is not made by parts, but altogether; producing an authority,* to which Mr. Good is never backward in paying due respect. Neither Boerhaave, Riverius, nor Hoffman, attempted any nosology, and the etiological, which is palmed on them, is, in fevers at least, more ctiargable on the latest and most popular of all the nosological writers. In our opinion, every division of diseases, from the days of Aretxus to Sauvage, was rather an arrangement for convenience than founded on any attempt at a phiiosophic system. Even Sauvage could scarcely deserve any other character. His descriptions are so minute, his authorities so universal, and, in all, the therapeutic part is so generally added, that his work may be called, if not a dictionary, a catalogue raisonneB, arranged according to certain distinctions which he fancied more convenient than by the alphabet.
The arrangement by distinctive symptoms, Mr. Good very properly observes, is the only one *vhich can be of any practical use. Symptoms by an accurate and well instructed observer may be ascertained, but the seat of a disease can often be only discovered when it is too late to apply a remedy. Mr. G. considers Sauvage's work as too diffuse, yet so useful, that the student who neglects to read it carefully through, neglects one of the most important parts of his education. We, on the contrary, though not less disposed to compliment that work, conceive that the student who reads it through carefully will totally mistake the author's intention, and rise with a mind darker than chaos and not less confused. This caution cannot, however, be necessary, because we do not believe there is a student in the world who could read it carefully through. As a book ol reference, it is invaluable, and as such will be found in every well-furnished medical library. The same may be said of all the succeeding nosologies, till we arrive at Cullcn. In Mr. Good's Physiological System of Nosology. 325 In contemplating the character of this illustrious professor, we know not whether to admire most his genius, his industry, or that elegance of style, which has done much to render physic a popular study. We ought to add, that, notwithstanding the great injury we conceive the most important part of medicine has suffered by him, we are not at all disposed to undervalue his talents, or to doubt the goodness of his intentions. Never can we forget the-modesty of that' note, u De Elephantiasis Lepra, Frambaesia, et Trichomate, t'TPOTE MORBIS A MEIPSO NUNQUAM VlSlS atUpHllS Statuei'6 non ausus sum." Had he extended the same remark to Camp and Tropical fevers, his work might have been as free from objections as such a work can be. But the great mischief that followed his system, arose from its becoming the text book for his lectures, and unfortunately many of his hearers, rendered arrogant from the just celebrity of their teacher, began and finished their medical education in a school which furnished so few sources of practical knowledge. They were taught, indeed, all that could be taught in an university; but too many considered, that in that school were unfolded all the arcana of physic. This is now so universally understood, that nothing more need be said on the subject. We shall, therefore, continue our remarks on the extracts we have made from Mr. Good.
Cullen, we are told, seeing the diffusiveness of his predecessor, attempted to include the whole in four classes. After pointing out the difficulties attending such an attempt, Mr, Good expresses his displeasure at what he conceives a too severe remark ex cathedra in Germany. Yet this advocate immediately afterwards admits " insurmountable faults" in the system of Cullen. Is not such a censure on such a science as medicine infinitely stronger than the remark from the German chair? We perfectly agree, however, "with Mr. Good, and only regret that the state of medicine was such in Cullen's days as to force from him a Nosology in any form.
The successors of Dr. Cullen, who have attempted tb improve him, have been, we are told, Mac Bride, Darwin, l^arr, and Young. Of Mac Bride, Mr. Good has saicl enough ; on Darwin, he has been pleasant enough, but such is the difference of taste, that we cannot help detaining our readers on the death-warrant, as Mr. Good is pleased to call it, of this system. What, let us ask, are the objects of nosology ? To distinguish diseases, it may be answered. And to what purpose ? That we may know how to treat an animal whose actions or external appearances are different from JJO. 233. c g their 226 Critical Analysis. their ordinary state. Now, if the business of arrangement is to teach us how to act, the first question will be, whether we must commence our operations instantly, or whether we may be allowed time even to consult ? And this makes the first grand division between acute and chronic diseases, in their attention to which, the ancients, without any nosological tables, so much exceeded the moderns. " The symptoms of a disease, (says Mr. Good,) indeed, have not unfrequently been said to constitute the disease itself. This is not perhaps strictly true; they are rather an algebraical character designating an unknown quantity, but which, in the hands of a skilful mathematician, may be managed as readily in working a proposition as if such unknown quantity were a sensible object.
" It is hence that the writings of Hippocrates and of Sydenham arc so highly and deservedly esteemed; and will be so as long as medicine shall be practised." Some remarks follow on Celsus, whom we shall presently attend to, and we could wish Aretams had been introduced also. Our first business, according to the instructions of these great men, and particularly the last named, is to discover symptoms which immediately endanger the life of our patient, or the destruction of some important organ. When these are relieved, we are called on for diagnosis and prognosis, and for these we require a most exact description of those external'appearances which mark the disease, and of the particular character in each which usually designate a favourable or fatal issue. Hence it follows, that, as in the same disease the symptoms are different in different stages, an arrangement to be useful must be modelled accordingly ; nor can we illustrate this better than by Mr. Good's objection to Darwin. It, when called to the bed-side of a person during the eruptive fever of small-pox, we discover synocha, are we to wait to see whether it will prove synochus, that is, typhus versus filially or whether iertio die iiicipit cruptio, &c. Should the case prove highly inflammatory, would not our patient be irretrievably lost by such delay ? If, on the other hand, the eruption has begun before we see our patient, arc we not to direct our attention to the symptoms immediately before us; and is a disease with an eruption and one without an eruption to be discovered by the same characters? It may be urged, that it bccomes us to make every enquiry. But this will lead us to etiology, the danger of attending to which in this state of things, we shall consider presently.
The great object then in acute diseases, is to enable ourselves to form a prompt decision, and it was not altogether erroneous that some of the ancients began their instructions by Mr. Good's Physiological System of Nosology. 227 by an immediate application to signa et agenda. Celsus, who cannot be considered an original author, before he discriminates any diseases by name, marks certain symptoms or signs which require or authorize blood-letting, vomiting, purging, and other active remedies, which the urgency of the symptoms may imperiously demand, even though we are ignorant what the disease may ultimately prove. This then we consider the first and most important division of diseases, and so important, that in our opinion it should be unfettered with any distant considerations, which may paralyze our attempts at giving immediate relief, or preventing fatal consequences.
But, to come nearer to the point, typhus is called febris contagiosa. The cflHse, therefore, is contagion, and unhappily this etiological distinction was thought a sufficient argument in favour of a practice which every family in the kingdom has, at different times, had cause to lament.
Let us recollect, that the ancients had none of the advantages we derive from the examination of those who have died of these fevers. Even Sydenham was deficient in this re. spect. But, by their mode of judging from the immediate symptoms, they acted with decision ; and experience lias shown, that, by such decision, they escaped those disasters which dissection has at last taught us are often the result of our nosological cautions.
Thus, whatever may be said of Darwin, to us, it appears, that, if the object of nosology is to direct us in diagnosis and practice, there is the utmost propriety in dividing small-pox into all the orders and genera which its appearance in its different stages exhibits.
Respecting Dr. Parr, in our opinion, when coupled with Mr. Good, he has, to use the expression of the latter, given the death-warrant to all nosology. " As a natural system, (says Mr. Good) even in botany, is, to the present hour, and perhaps always will be, a theoretical rather than a practical idea, there seems very little expectation that it can ever be realized in medicineNow, without the necessity of a pun, the stud}'-of physic is the study of nature, and of all the branches of that study, medicine is the most important, ancl that which requires the most immediate reduction to practice; any thing, therefore, which takes off our attention from the immediate operations of nature is dangerous. If diseases were to be exhibited like fossils or plants, it would matter but little how artificial their arrangement might be. * See above, page 216.

Gg2
Chemical 228 Critical Analysis? Chemical proportions, general configuration, or the form of certain parts at a certain period of existence or growth, may be sufficient for subjects on which we operate at our leisure, or which Ave turn to and produce as often as we wish to point out their distinguishing characters. Is such the object in designating acute diseases? At some very distant period, it may be accomplished in chronic cutaneous complaints, but, for this purpose, hospitals, sufficiently capacious, must be endowed, in which professors, sufficiently honest and enlightened, must preside. This leads us to the consideration of those attempts of some authors to form a nosology of only certain " groups or families of diseases or monograms." Of these, Plenck, Willan, and Bateman, are principally noticed. The two latter have frequently come before us, we shall, therefore, only slightly mention the objections we find made to Willan, reserving our further remarks to the instances we shall produce from the system of nosology before us. Willan is said to be best suited for his restricted system, and that it would not well be interwoven into a larger plan. " As it is, indeed, it stands in need of no small degree of modification to clothe it with all the perfection it deserves; for several of liis orders would make better genera; almost all his genera are decided species, while his species are seldom more than varieties, and are in mat*/ cases so denominated by himself." We confess ourselves not prepared to admire a part which will not adapt itself to a whole, nor a whole which will not harmonize with a well-constructed part. At length we have arrived at Mr. Good's own plan, as stated in his preliminary dissertations. The general remarks on language have been already noticed. We now add, that it is with much pleasure we find no admission to pseudos and oideses, those disgraceful subterfuges of ignorance or indolence. We are aware such terms are to be met with in the methodical synopsis, or systems of other branches of natural history. But, besides what we have before remarked of the impropriety of attempting to confine nosology to the same artificial laws, we may add, that every science has divested itself of these terms in proportion as it has been more correctlytaught. Ray, in his Synopsis Plantarum, omits four out of five pseudos, and Linnaeus admits none. The latter is not less careful in discarding the oideses. Can there be a more wretched view of the most important science, than that, in the present day, it should avail itself of terms discarded by -all the reformers in the other branches of natural philosophy. ? After Mr. Good's Physiological System of Nosology. ogg After our decided ,approbation of Mr. Good's diligence, and, as far as our inquiries have extended, his accuracy in terminology, it is with no small concern, that, as soon as we enter on his arrangement, we meet with the words nosology and pathology used as synonymous. Pathology has always been applied to that knowledge by which, from the sufferings of the patient, we may detect the nature, if not the seat of his disease. Nosology is a modern science as well as a modern word, and, by the moderns, is applied to an artificial arrangement, by which we are to ascertain the order, class, genus, or species, of diseases.
We are absolute^ frightened, when we re-peruse our own words, and still more so, when we recollect that we have been reading of " groups and even families of diseases," and that the arrangement or march of these is to vary according to the taste of every fresh nosologist. Can there be a stronger proof of the impracticability of accomplishing an object than that no two writers should agree, and that, in the midst of their attempts, they should lose sight of the only purpose to which every thing useful in the study of medicine is directed. Mr. Good informs us, that he has preferred according to the plan of modern physiologists, to take for his arrangement the animal frame in its more mature and perfect state, and trace it from some well defined and prominent function. He then speaks of links in a chain, and urges the simplicity of his plan as according with all the systems of zoology, botany, and mineralogy, forming the arrangement, and selecting the characters from the most perfect individuals as specimens. Is it possible, this learned and ingenious writer, after nine years' consideration, is not aware that this very sentence renders his whole labours useless or something worse. In every acute disease, are we to wait for the maturity and perfection of our specimen ??
Certainly not; but, it may be answered, by accurately ascertaining the true character from such a specimen in its most mature and perfect state, we ascertain the true disease, and, having once done so, it will not be difficult to mark the varieties. Can we wish, let us ask, for a more perfect specimen of small-pox and its varieties than Sydenham pffers, or of the gout, or of fevers, than we meet with m the same writer; or of the venereal disease, in all its forms, than Mr. Hunter presents us; or of scarlatina, than Fothergili's ; of elephantiasis, than Dr. Adams's; or of bronchitis, than Badman's ? ? And what assistance have they derived from artificial arrangement ? But, it will be said, if we wish to avail ourselves of the labours of others, or 2 to 230 Critical Analysis.
to render our own useful, some method is necessary for concentrating the result of these labours. True?then, as we before remarked, nosology is a catalogue raisonnee of diseases and of authors; and, if so, we shall leave every writer to chuse his own mode, and the public will judge which is the handiest. For our parts, we have no objection to any, excepting as they endanger decision in the practice of acutc diseases, and in chronic or local complaints encourage indolence, by substituting terms for well-defined descriptions.
On the influence of nosology in acute diseases, we have already said enough; in chronic complaints, we shall find ample opportunities when we come to notice the various parts of the arrangement before us.
Mr. Good concludes his prolegomena by some remarks on the oriental synonyms and writers. Of the accuracy of these it is not in our power to judge, nor have we, as on all other occasions, consulted those who might give us information. The truth is,, we were unacquainted with any medical gentleman who pretended to a critical knowledge of those languages. We felt, indeed, at first, some alarm from learning that " no one ought to pretend to a scientific acquaintance with cutaneous diseases, who has not studied Serapion; nor to a practical history of small-pox, who has not read the pages of Rhazes." Yet it appears, on the same authority, that Willan was unable to read Serapion, and we have no proof that Sydenham knew any thing of Rhazes; yet the honest Boerhaave advised his hearers to read Sydenham, plus quavi dccies. Probably Boerhaave might be ignorant of the treasures contained in Rhazes. Such was not, however, the case with Mead, who procured Latin translations of his work from two different sources, and collated them with the highest authority in his days; yet, after all, he only speaks of Rhazes as containing an imperfect detail of what he knew before, and even demands ample "allowance for time and place." This is very different from his language when speaking of his countryman Sydenham?of whom he remarks that he was the "first who divided that disease into different stages, and gave the method of cure in each." Besides the English translation of Rhazes, by Mead, we have one in Latin, by Mr. Channing, an apothecary of considerable practice in London. This gentleman, after a laborious study, repaired to Oxford, that he might have a more perfect acquaintance with oriental literature, and was so ready at Arabic, that his private memorandums were all made in that language. His translation of Rhazes is from a MS. at Leyden. He has also added the Almanzor, but from Mr. Good's Physiological System of Nosology. ?s t from authorities loss certain. After the perusal of these translations of the best Arabic works in physic, we feel less regret at our ignorance of thaf language,, especially when Ave reflect on the first aphorism of the Grecian sage, and that we have heard profound scholars, not destined for medicine, regret the time they had lost in the acquisition of oriental literature. The best part, as far as relates to science, is well known to consist of translations from the Greek. Even Rhdzes, in this celebrated work, would gladly have discovered small-pox in the writings of Gaien,?an attempt about as successful as the researches of a modern writer into Hippocrates for a similar purpose.
Whilst we thus submit, perhaps it will be.said from necessity, to our ignorance, we feel the more obliged to those who have undertaken a labour from which we have shrunk. Etymology cannot be without its uses, and as Mr. Good has furnished us with the oriental words in their proper characters, we trust, in a future edition, he will imitate Mr. Tooke in furnishing u:* with alphabets, or an alphabet, with directions how to use it. " Occasionally," we are told, '' where the Arabic names are also Persian or Turkish, the author has added the initials, or other marks of these cognate tongues, and, in a few instances in which they are peculiarly expressive, he has also superadded the Persian or Turkish names, even though different from the Arabic. At times, indeed, the Arabic writers themselves employ a Persian or byriac term, for several of them were of Persian or Syrian birth, and in such cases the author has also indicated the proper origin: all which has been a labour of no -small trouble, from the novelty of the attempt, and the difficulty of procuring medical Arabic and other eastern books that would answer the purpose." It is impossible to doubt the author's diligence, nor can we wonder if, in the midst of such multifarious inquiry intolanguag.es, he has occasionally become obscure in his own.
We shall here conclude our remarks on the introductory part of the work. The reader may think them long, but we can assure hiin they are much shorter than our first MS.
The extracts are, indeed, more copious, as we are alwaj^s fearful of doing injustice to an author by partial quotations, or by offering his opinions in words at all different from his own.
Where we differ from him, this is particularly necessary; and, where we agree, there is always danger lest by transferring his thoughts into our own words, we should seem to claim his discovery for our own. It is, however, Only one objection occurs to us, which it will be time enough to notice when we arrive at a passage in which the term is introduced.
In examining the execution of the work, we had determined to proceed seriatim. But, as this might prove less interesting to ourselves, and, as we apprehended, to our readers, after a minute attention to the first article, we con. tented ourselves with those which appeared more connected with nosological controversy, and some of which having tome lately before us would be more fresh in our readers' [Here follows a note concerning the progress of dentition in the temporary and permanent teeth.] " 1. y O. dentitionis, Adultorum.?The cutting of these teeth often attended with peculiar pain and inconvenience, especially when the process takes place very late, and consequently after the jaw-bones have ceased to grow : for we have in this ca?e otten a want of sufficient room, and, in the upper jaw, the tooth 011 each sid?*. is frequently obliged to grow backward, in which position it sometimes presses ou the anterior edge of the coroncrid process in shutting the mouth, and consequently gives considerable pain. When the same fact takes place in the lower jaw, some part of the tooth continues to lie hid under that process, and covered by the ioft parts, which are always liable to be squeezed between the new tooth and the corresponding one in the upper jaw. Nothing but a ree opening will ever sutlice in this case, nor even this always; i'or at times the evil can only be cured by removing the tooth itself. For the most part, the teeth shoot forth irregularly, and few in fiumber, so as to be of little benefit, and sometimes more injurious than useful, by preventing the approximation of the callous gums, which till now had been employed as a substitute for the teeth. In one instance, though only in'one, Mr. J. Hunfer informs us, that lie was witness to the reproduction of a complete set in both jaws: and he supposes that in all these cases a new'alveolar process is formed, as in the preceding sets. ' From this circumstance,' says he, 'and another that sometimes happens to woriien at this age, it would appear that there is some effort in nature to renew the body at that period.' iame conclusion. The author once attended a lady who cut several straggling teeth at the age of seventy-four, and at the same time recovered her sight so completely as to throw away her spcctaclcs, which she had made use of for twenty years, and to be able to read with ease the smallest print in the newspapers. In another case that occurred to him, a lady of seventy-six cut two molares, and at the same time completely recovered her hearing, after having, for some years, been so deaf as to be obliged to feel the clapper of a small hand-bell, which she always kept by her on a table, in order to know whether she made it ring. " One of the most singular instances on record is that given by Dr. Slare in the Phil. Trans, vol. xxvii. 1713, as it occurred to his father. At the age of seventy-five, he renewed an incisor lost twentyfive years before; at seventy-seven, he renewed an incisor to supply a similar vacancy'; at eighty, all his teeth were hereby rendered perfect; at eighty-two, they all dropped out successively; two years afterwards they were all successively renewed, so that at eighty-live he had an entire new set. His hair simultaneously ! changed from a white to a dark hue, and his constitution seemed somewhat more healthy and vigorous. lie died suddenly at ninetynine or a hundred. " 2. Vdontia dolorosa. The varieties are abridged from Cullen, or rather from Sauvages, from whom Cullen has copied them. In the earlier editions of Cullen's Nosology, odontia dolorosa (odontal- Maj gia as he terms il) is arranged as a species of rheumatism after Hoffman. In the fourth and succeeding editions it is raised to the rank of a distinct genus, and placed (xxii) between arthrodvnia and podagra. The Anglo-Saxon name for tins affection was toth-ece. " There may possibly be other varieties than are here offered. Every tooth ha** an internal cavity, which commences at the point of its fang, and enlarge-) as it ascends into its body. This cavity is Not cellular, but smooth in its surface; it contains no marrow, but appears to be tilled with blood-vessels, which are doubtless accompanied with nerves, which must necessarily be derived from the second and third branches of the fifth pair, though they have never been distinctly traced. In tile interior of this cavity the teeth appear to be peculiarly sensible, and hence direct or indirect exposure' to the external air, or, in other words, a carious aperture, or a current of sharp <;ir without such aperture, (for the air seems, in many instances, to act through the substance of a sound tooth), will be *>ufficieui to produce acute pain, and is, in fact, the common cause of tooth-ach: on which account, the readiest modes of cure consist in stopping up the aperture with metal or some other substance, de-fending the tooth from the access of cold, or destroying the nerve by caustics or cauteries through the aperture itself. " Perhaps the pain called scorbutic may be regarded as an example of the sympathetic variety: that from gout is for the most part a real transfer of action, the organ previously affected being; generally at ease, or nearly so, during its continuation. " For tlu* caries of perfect teeth it is not easy to account. Out of the body they are indestructible, excepting by very powerful chemical agents; and >et, in the judgment of many physiologists, they are nearly in the same state in the body as out of il, being extraneous substances formed complete at first, without vascularity, growth, or internal action, and even destitute of absorbents. Such, at least, was the opinion of Mr. J. Hunter when composing his ?Natural History of the Unman Teeth,' an opinion drawn from the impossibility of injecting them, the perfection in which they are Produced at first, and their retaining their natural colour alter so '?ug a use of madder as a food, that all the other bones ot the body have become thoroughly tinged with it. ' But they have most certainly,' says he, 'a living principle, by which means they make part of the body, and are capable of uniting with any part ot a living body; and it is to be observed, that affections of the whole body have less influence upon the teeth than upon any other part of the body, j hu* in children affected with the rickets, the teeth grow equally well as in health, though all the other bones are much .affected; and hence, their teeth being of a larger size in proportion \o the other parts, their mouths are protuberant/ " Admitting the soundness of these experiments, and the accuracy , h h 2 of 230 Critical Analysis.
Mai de dents. F. Tooth-ache a Cariosa, qf this reasoning, it seems impossible that the teeth, when once perfectly produced in the gums, should ever decay: for no action of the living principle cau occasion a secretion of those chemical agents which would alone, in such case, be capable of destroying them. It is probable, therefore, that this reasoning is erroneous, and that the teeth are vascular, though the art of injection is incapable of tracing the vascular structure, and the colouring particles of madderroot are not sufficiently attenuate to enter their vessels. Mr. Hunter himself, indeed, appears to speak with some degree of hesitation in the treatise before us; and, in his subsequent treatise ' On the Diseases of Teeth,' offers observations that seem to show he had at that ^ime embraced a different opinion. In the first essay, indeed, he allows that ' the fangs of teeth are liable to swellings, seemingly of the spina ventosa kind, like other bones;' but he immediately adds, that ' there may be a deception here, for the swelling may be an original formation.' Yet, in the second essay, he treats of this swelling as one of the diseases to which the teeth are perpetually liable: he regards the teeth as subject to the common inflammation of other bones, and, like other bones, evincing at times great sensibility through the entire substance of the organ, as well as in the central cavity itself. Nor is it quite certain that the body of a tooth does not occasionally enlarge as well as its fangs ; for nothing is more common than for the space produced by extracting one of the grinders of a healthy adult to be filled up by an approximation of the two adjoining teeth. Mr. Hunter, indeed, endeavours to account for this, by supposing that each of these teeth has been pressed into the vacancy by the teeth behind them, in consequence! of their \*ant of a proper support in this direction; but, in such case, there must be some vacuity discoverable between themselves and the teeth which have thus urged them forward. In various cases, the author has never been able to trace any such vacuity whatever; and has a decisive example to the contrary in the state of his own teeth:, for having, when a boy of twelve years old, had the second of the bicuspidati extracted, the vacancy thereby produced has been so completely filled lip by the enlargement of the adjoining teeth, that these teeth closely touch, and he is only able to introduce a fine probe between them at the neck, or lowest and narrowest part; while he can introduce nothing between any of the other teeth, which have in no respect given Way or separated from each other. municating between the parts in contact. Nor is there any more reason why teeth should not decay because they are extraneous to the neighbouring parts, than that hydatids should not die. But, whether healthy teeth are vascular or not, must be a matter of conjecture till we can discover their vessels. Mr. Hunter has not overlooked the impossibility of the teeth becoming diseased by those menstrua *vhich have a power of destroying part of a tooth, " for any thing of this kind (says he) could not act so partially;"* and it is worth while to mark the coincidence of language between Mr. Hunter and Mr. Good in their account of the various diseases of the teeth, and even in their causes, excepting that the one makes no mention of those external causes, of the existence of which the other has " no doubt." We suspect, however, the events act with too little uniformity to be admitted as of " no doubt." We shall see too, that Mr. Hunter has not been inattentive to all that Mr. Good describes in his own case. In his chapter " Of the Irregularity of the Teeth," Mr. H. shows, that the vacancy from the loss of